Hypertension and Frailty Syndrome. A Narrative Review of Clinical and Pathophysiological Evidence

Abstract

Introduction: hypertension and frailty syndrome are prevalent and clinically relevant conditions in the older adult population. Although traditionally addressed separately, current evidence suggests a complex interaction between them, mediated by shared pathophysiological mechanisms such as chronic inflammation, arterial stiffness, and endothelial dysfunction. Objective: this review aims to synthesize and analyze this bidirectional relationship, addressing its pathophysiological and clinical aspects, with the purpose of contributing to a more individualized clinical approach in a context of aging and multimorbidity. Methods: a narrative literature review with a structured methodology was conducted. A literature search was performed in PubMed and LILACS and included articles published between January 2015 and November 2025, using controlled vocabulary and free-text terms combined with Boolean operators. Systematic reviews, observational studies, clinical trials, post hoc analyses, clinical guidelines, and consensus documents were analyzed, including studies with methodological quality considered acceptable or (...)